Cutaneous-pericardial fistula and purulent pericarditis secondary to a complicated pericardiocentesis: Case report
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Keywords
Pericarditis, Cutaneous Fistula, Pericardiocentesis, Lymphoma
Abstract
Background: Cutaneous-pericardial fistulas are rare, with only isolated case reports related to infectious complications. We present here a complicated case of a patient who developed a cutaneous-pericardial fistula with secondary purulent pericarditis. We also include a review of the 15 reported cases of cutaneous-pericardial fistula in the literature.
Clinical case: A 44-year-old man diagnosed with non-Hodgkin lymphoma presenting with cardiac tamponade underwent pericardiocentesis with placement of an indwelling drainage catheter. Six weeks after catheter removal, he developed a cutaneous-pericardial fistula with purulent pericarditis, the microbiological isolation was Staphylococcus aureus methiciline susceptible (SAMS). He was admitted to the intensive care unit (ICU) with diagnosis of mixed shock (obstructive and septic) and multiple organ failure. A pericardial window was performed, and he received 8 weeks of antibiotic therapy with cepahlothin along with an integral management stablished by the ICU service. He presented a favorable outcome and resolution of infection.
Conclusions: This case illustrates a rare and serious complication with a hig risk of mortality. It is essential to strengthen monitoring and care of pericardial drains, as well as to consider early signs of infection to provide timely surgical and antimicrobial treatment.
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